Microwave ablation catheter, handle, and system

ABSTRACT

A handle for longitudinal movement of a first tubular member over a second tubular member includes a handle body, a nose cone, a locking mechanism, and a retraction control. The nose cone has a sleeve and an outer wall that define a control channel therebetween. The nose cone is moveable over the handle body between extended and retracted positions. The locking mechanism has locked and unlocked positions for selectively fixing the nose cone in the extended and retracted positions. A finger of the retraction control is positioned within the control channel of the nose cone. The retraction control has first and second positions relative to the nose cone for transitioning the locking mechanism between the locked and unlocked position and for moving the nose cone between the extended and retracted positions.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.16/779,861, filed on Feb. 3, 2020, which is a continuation of U.S.patent application Ser. No. 15/870,850, filed on Jan. 12, 2018, now U.S.Pat. No. 10,561,463, which is a continuation of U.S. patent applicationSer. No. 14/479,482, filed on Sep. 8, 2014, now U.S. Pat. No. 9,867,665,which claims the benefit of the filing date of provisional U.S. PatentApplication Nos. 61/874,881, filed on Sep. 6, 2013; 61/974,611, filed onApr. 3, 2014; and 62/041,424, filed on Aug. 25, 2014.

FIELD

This disclosure relates to surgical instruments and, more specifically,to handles for moving an outer tubular member relative to an innertubular member inserted therethrough.

BACKGROUND

A common interventional procedure in the field of pulmonary medicine isbronchoscopy, in which a bronchoscope is inserted into the airwaysthrough the patient's nose or mouth. The structure of a bronchoscopegenerally includes a long, thin, flexible tube that typically containsthree elements: an illumination assembly for illuminating the regiondistal to the bronchoscope's tip via an optical fiber connected to anexternal light source; an imaging assembly for delivering back a videoimage from the bronchoscope's distal tip; and a lumen or working channelthrough which instruments may be inserted, including but not limited toplacement (e.g., guide wires), diagnostic (e.g., biopsy tools) andtherapeutic (e.g., treatment catheters or laser, cryogenic, radiofrequency, or microwave tissue treatment probes) instruments. The distaltip of a bronchoscope is steerable. Rotating a lever placed at thehandle of the bronchoscope actuates a steering mechanism that deflectsthe tip in one or more directions.

Bronchoscopies are performed by pulmonologists, also known asbronchoscopists, and are used routinely in the diagnosis and treatmentof conditions such as lung cancer, airway stenosis, and emphysema.Bronchoscopies are typically performed by a staff of at least twopersons: the bronchoscopist and at least one assistant, usually a nurse.During a typical procedure, the bronchoscopist holds the bronchoscopehandle with one hand and the bronchoscope tube with the other hand. Thebronchoscopist manipulates the distal tip of the bronchoscope inside thelung by rotating a deflection lever and by pushing and pulling the tube.Once the tip is brought to a target, an instrument can be inserted intothe working channel to perform a diagnostic or therapeutic procedure.

During insertion and operation of the instruments, the distal tip of thebronchoscope should be held steady at the target. Two hands are neededto secure the bronchoscope in place and one to two more hands are neededfor inserting and actuating the instrument. Generally, thebronchoscopist releases the bronchoscope to insert and actuate theinstrument. Performing a procedure that requires two people is generallymore expensive and the potential for error is increased. Hence, it isdesirable to modify a procedure so that it may be performed with one ortwo hands, if possible.

Additionally, because all of the instruments used with a bronchoscopeare necessarily long and slender, the instruments do not retain shapewhen unsupported. Thus, inserting an instrument into a bronchoscope canbe difficult or impossible to do quickly with one hand. While thisproblem can be addressed easily by holding the end of the sheath in onehand and the instrument in another, this would again require additionalfree hands during performance of the procedure.

During particular procedures (e.g., microwave ablation and biopsy) acatheter or extended working channel may be inserted through a workingchannel to enable navigation to sites too remote and having luminaldiameters too small for the bronchoscope. An instrument may be insertedthrough the catheter or extended working channel in order to perform abiopsy or ablation procedure. Current systems and methodologies forextending the surgical instrument from the catheter or retracting thecatheter from the placement of the surgical instrument require at leasttwo people to manipulate all the elements of the system including thebronchoscope.

Accordingly, there is a need for an apparatus that would facilitateone-handed actuation of the catheter and surgical instrument leaving onehand to manipulate the bronchoscope. In addition, there is a need for asupport for use with a bronchoscope that would facilitate operation of abronchoscope and associated tools by a single practitioner. It wouldalso be advantageous to provide a support for the probe and the catheterto allow a single practitioner to manipulate a catheter, a probe, and abronchoscope during the procedure.

SUMMARY

In an aspect of this disclosure, a handle for longitudinal movement of afirst tubular member over a second tubular member includes a handlebody, a nose cone, a locking mechanism, and a retraction control. Thenose cone has a sleeve and an outer wall defining a control channeltherebetween. The nose cone is moveable over the handle body betweenextended and retracted positions. The locking mechanism has locked andunlocked positions for selectively fixing the nose cone in the extendedand retracted positions. The retraction control includes a fingerpositioned within the control channel of the nose cone and has first andsecond positions relative to the nose cone for transitioning the lockingmechanism between the locked and unlocked positions and for moving thenose cone between the extended and retracted positions.

In aspects, when the nose cone is in the extended position and theretraction control is in the first position, the locking mechanism is inthe locked position to fix the nose cone in the extended position.

In some aspects, when the nose cone is in the extended position and theretraction control is in the second position, the locking mechanism isin the unlocked position such that the nose cone is moveable relative tothe handle body. When the nose cone reaches the retracted position, thelocking mechanism transitions to the locked position to fix the nosecone in the retracted position.

In certain aspects, when the nose cone is in the retracted position andthe retraction control is in the second position, the locking mechanismis in the locked position to fix the nose cone in the extended position.

In particular aspects, when the nose cone is in the retracted positionand the retraction control is in the first position, the lockingmechanism is in the unlocked position such that the nose cone ismoveable relative to the handle body. When the nose cone reaches theextended position, the locking mechanism may transition to the lockedposition to fix the nose cone in the extended position.

In aspects, the second position of the retraction control is proximal tothe first position of the retraction control. The locking mechanism maybe disposed within a slot defined in the housing body. The lockingmechanism may include a locking pin that has a retention plate. Thelocking pin may be biased out of the slot defined in the housing bodysuch that the retention plate retains the locking pin within the slot.The sleeve of the nose cone may define first and second openings suchthat when the nose cone is in the extended position and the locking pinis in the locked position, the locking pin is disposed within the firstopening. In addition, when the nose cone is in the retracted positionand the locking pin is in the locked position, the locking pin may bedisposed within the second opening.

In another aspect of this disclosure, a surgical system includes anextended working channel having proximal and distal ends, a handledefining a through passage, a retraction control, and a catheterassembly disposed within the through passage of the handle. The handleincludes a housing body defining a proximal portion of the throughpassage, a nose cone coupled to the proximal end of the extended workingchannel, a locking mechanism, and a retraction control. The nose conehas a sleeve and an outer wall defining a control channel therebetween.The nose cone defines a distal portion of the through passage incommunication with the extended working channel. The nose cone islongitudinally moveable over the housing body between extended andretracted positions. The locking mechanism has locked and unlockedpositions for selectively fixing the nose cone in the extended andretracted positions. The retraction control includes a finger positionedwithin the control channel of the nose cone. The retraction control hasfirst and second positions relative to the nose cone for transitioningthe locking mechanism between the locked and unlocked positions and formoving the nose cone between the extended and retracted positions. Thecatheter assembly includes a catheter hub positioned within the proximalportion of the through passage and an ablation probe extending from thecatheter hub through the nose cone of the handle and through theextended working channel. The ablation probe has a distal end that isdisposed within the extended working channel when the handle is in theextend position and that is position positioned distal to the distal endof the extended working channel when the handle is in the retractedposition.

In aspects, the catheter hub combines coolant tubes and an antenna intothe ablation probe. The catheter hub may include an adjustment nut thatis positioned over an outer surface of the catheter hub. The housingportion may define a nut recess for receiving the adjustment nut tolongitudinally fix the ablation probe to the housing portion. Theadjustment nut is threaded to cooperate with threads on the outersurface of the catheter hub to allow fine adjustment of the length ofthe ablation probe relative to the housing portion. The distal end ofthe ablation probe may be positioned within the distal end of theextended working channel when the nose cone is in the extended position.The distal end of the ablation probe may be positioned distal to thedistal end of the extended working channel when the nose cone is in theretracted position.

In another aspect of this disclosure, a method of assembly of a surgicalsystem includes positioning a catheter assembly within a half of a firstportion of a passage defined within a first half of a housing body of ahandle, securing a second half of the housing body of the handle to thefirst half of the housing body with the catheter assembly that ispositioned in a half of the first portion of the passage defined withinthe second half of the housing body to form the housing body, sliding anose cone of the handle over a distal portion of the housing body, andinserting a finger of a retraction control within a control channeldefined between a sleeve and outer wall of the nose cone. The nose conedefines a second portion of the passage that receives a probe of thecatheter assembly therethrough.

In aspects, the positioning of the catheter assembly within the firsthalf of the first portion of the passage that is defined within thefirst half of the housing body includes position an adjustment nutwithin a nut recess defined in the housing body to adjust the length ofthe probe extending distally from the housing body. The method mayfurther include rotating the adjustment nut about a threaded portion ofthe catheter hub to fix the length of the probe that extends distallyfrom the housing body. Securing the second half of the housing body tothe first half of the housing body may prevent adjustment of the lengthof the probe extending distally from the housing body during use of thesurgical system.

In another aspect of this disclosure, a support system includes a rail,a lower support, and an instrument support. The rail has upper and lowerends that define a longitudinal axis therebetween. The lower support isconfigured to receive a portion of a bronchoscope and to selectively fixthe bronchoscope relative to the rail. The instrument support isslidably disposed on the rail and is selectively lockable to the rail.The instrument support is configured to releasably couple to a surgicalinstrument inserted through the bronchoscope to fix the position of aportion of the surgical instrument relative to the bronchoscope.

In aspects, the instrument support includes a clamp arm and a clamp armcollar. The clamp arm collar may be slidably disposed over the rail. Theclamp arm may include instrument fingers that extend from the clamp armcollar. The instrument fingers may define an instrument passage that isconfigured to releasably couple to the surgical instrument. Theinstrument support may include a locking arm that has a locking cam. Theclamp arm collar may include a camming surface and the locking cam maybe configured to compress the camming surface of the clamp arm collaragainst the rail when the locking arm is in the locked position to lockthe instrument support to the rail. In the locked position, theinstrument support may be radially locked relative to the rail.

In some aspects, the lower support defines a rail opening that isconfigured to receive the lower end of the rail. The support system mayinclude a collar positioned within the rail opening that includes athreaded portion. The support system may include a securement memberthat is threaded over the threaded portion of the collar to compress thecollar over the lower end of the rail to fix the rail to the lowersupport.

In certain aspects, the lower support includes a pair of support fingersthat extend orthogonally from the rail. The support fingers may define asupport opening therebetween. The support fingers may be configured tocompress the support opening about the bronchoscope to fix the lowersupport relative to the bronchoscope.

In another aspect of this disclosure, a surgical system includes abronchoscope, an extended working channel that extends through thebronchoscope, an elongated surgical instrument that is inserted throughthe extended working channel, and a support system for supporting theelongated surgical instrument relative to the bronchoscope. The supportsystem includes a rail, a lower support, and an instrument support. Therail has upper and lower ends that define a longitudinal axistherebetween. The lower support is fixed to the lower end of the railand to the bronchoscope to fix the rail to the bronchoscope. Theinstrument support is slidably disposed on the rail and is selectivelylockable to the rail. The instrument support is releasably coupled to afirst portion of the elongated surgical instrument to fix the positionof the first portion of the elongated surgical instrument relative tothe bronchoscope.

In aspects, a second portion of the elongated surgical instrument ismoveable relative to the bronchoscope. The second portion of theelongated surgical instrument may be fixed to a proximal end of theextended working channel such that the extended working channel ismoveable relative to the bronchoscope and the first portion of theelongated surgical instrument. The first portion of the elongatedsurgical instrument includes an ablation probe that extends through thesecond portion of the elongated surgical instrument and the extendedworking channel.

In some aspects, the extended working channel includes a telescopicextended working channel handle that is fixed to the bronchoscope. Whenthe telescopic extended working channel handle is manipulated, thebronchoscope and the elongated surgical instrument that is fixed to thebronchoscope by the support system move in concert with the telescopicextended working channel handle.

In another aspect of this disclosure, a method of positioning anelongated surgical instrument adjacent targeted tissue includesinserting the elongated surgical instrument into an extended workingchannel, securing a support system to the bronchoscope, coupling aportion of the elongated surgical instrument to the support system tofix the portion of the elongated surgical instrument to thebronchoscope, and manipulating a portion of the extended working channelsuch that the bronchoscope, the elongated surgical instrument, and thesupport system move in concert with the portion of the extended workingchannel. The elongated surgical instrument may have a locatable guideadjacent a distal end thereof. The extended working channel passesthrough a bronchoscope positioned in an airway of a patient.

In aspects, manipulating a portion of the extended working channelincludes manipulating a telescopic extended working channel handle ofthe extended working channel that is connected to the bronchoscope.

In some aspects, securing the support system to the bronchoscope mayinclude fixing a lower support of the support system to a portion of thebronchoscope. Securing the support system to the bronchoscope mayinclude inserting a lower end of a rail of the support system into thelower support.

In certain aspects, coupling a portion of the elongated surgicalinstrument to the support system includes coupling the portion of theelongated surgical instrument in an instrument support of the supportsystem. The method may include locking the instrument support to a railof the support system to fix the portion of the elongated surgicalinstrument relative to the bronchoscope.

Further, to the extent consistent, any of the aspects described hereinmay be used in conjunction with any or all of the other aspectsdescribed herein.

BRIEF DESCRIPTION OF THE DRAWINGS

Various aspects of this disclosure are described hereinbelow withreference to the drawings, which are incorporated in and constitute apart of this specification, wherein:

FIG. 1 is a perspective view of an exemplary surgical system including aretraction handle and a rail system in accordance with the disclosure;

FIG. 2 is a perspective view of the retraction handle of FIG. 1 ;

FIG. 3 is an exploded perspective view showing the components of theretraction handle of FIG. 1 ;

FIG. 3A is a cross-sectional view taken along the section line 3A-3Ashown in FIG. 3 ;

FIG. 4 is a longitudinal cross-sectional view of the retraction handleof FIG. 1 taken along the longitudinal axis thereof;

FIG. 5 is an enlarged view of the indicated area of detail of FIG. 4 ;

FIG. 6 is a longitudinal cross-sectional view of the retraction handlewith the retraction control in a second position and the nose cone in anextended position;

FIG. 7 is an enlarged view of the indicated area of detail of FIG. 6 ;

FIG. 8 is a longitudinal cross-sectional view of the retraction handlewith the retraction control in the second position and the nose cone inthe retracted position;

FIG. 9 is an enlarged view of the indicated area of detail of FIG. 8 ;

FIG. 10 is a longitudinal cross-sectional view of the retraction handlewith the retraction control in the first position and the nose cone inthe retracted position;

FIG. 11 is an enlarged view of the indicated area of detail of FIG. 10 ;

FIG. 12 is a perspective view of a distal end of the catheter of FIG. 2;

FIG. 13 is a perspective view of the distal end of the catheter of FIG.12 when the retraction handle is in the retracted position;

FIG. 14 is an enlarged view of the indicated area of detail of FIG. 1 ;

FIG. 15 is a side cross-sectional view of taken along the section line15-15 of FIG. 14 ;

FIG. 16 is an enlarged view of the indicated area of detail of FIG. 1 ;

FIG. 17 is a top view of a device support taken along the line 17-17FIG. 16 illustrating a locking arm in an unlocked position;

FIG. 18 is a top view of a device support taken along the line 18-18 ofFIG. 16 illustrating a locking arm in a locked position;

FIG. 19 is a perspective view of the surgical system of FIG. 1 in usewith an electromagnetic navigation system 400 provided in accordancewith the disclosure;

FIGS. 20A-20C are side views of distal ends of instruments that may beused with the surgical system of FIG. 1

FIG. 21 is a perspective view of another rail system provided inaccordance with the disclosure;

FIG. 22 is an enlarge perspective view of the area of detail indicatedin FIG. 21 ;

FIG. 23 is a cross-sectional view taken along the section line 23-23 ofFIG. 22 ;

FIG. 24 is a perspective view of the lower support of FIG. 22 with thesupport arm in an open configuration positioned about a portion of abronchoscope;

FIG. 25 is a perspective view of the lower support of FIG. 24 with theportion of the bronchoscope removed;

FIG. 26 is a cross-sectional view taken along the section line 26-26 ofFIG. 21 illustrating the instrument support in an unlockedconfiguration;

FIG. 27 is a cross-sectional view of the instrument support of FIG. 27in a locked configuration; and

FIG. 28 is a perspective view of the rail system of FIG. 21 with anotherinstrument support provided in accordance with the disclosure.

DETAILED DESCRIPTION

According to aspects of this disclosure, a support system mounts to abronchoscope to support instruments inserted through and associated withthe bronchoscope. In one embodiment, the support system is configured toseparately support a retraction handle and a catheter inserted throughthe retraction handle and the bronchoscope. The retraction handle iscoupled to an extended working channel that passes through thebronchoscope and into the anatomy of a patient. The catheter is insertedthrough the extended working channel to a position adjacent targetedtissue. When the catheter is positioned adjacent the targeted tissue,the retraction handle is moved to a retracted position to expose thedistal end of the catheter adjacent the targeted tissue such that thecatheter can treat the targeted tissue. The retraction handle may bemoved to the retracted position with one hand of a clinician as detailedherein.

Embodiments of this disclosure are now described in detail withreference to the drawings in which like reference numerals designateidentical or corresponding elements in each of the several views. Asused herein, the term “clinician” refers to a doctor, a nurse, or anyother care provider and may include support personnel. Throughout thisdescription, the term “proximal” refers to the portion of the device orcomponent thereof that is closest to the clinician and the term “distal”refers to the portion of the device or component thereof that isfarthest from the clinician.

Referring now to FIG. 1 , a surgical system 10 includes a bronchoscope11, a telescopic extended working channel (EWC) handle 15, an ablationcatheter assembly 100, including a cable 18, a probe 19, a retractionhandle 20, and a connector 21 for connection to an energy source such asa microwave generator (not shown). A portion 18 a of the cable 18 mayextend from the connector 21 to a coolant source (not shown) forproviding a cooling fluid to the ablation catheter assembly 100. FIG. 1also depicts a rail system 300 including a support rail 312 supported onthe bronchoscope 11 by a lower support member 320 and includes a devicesupport 330 that supports the retraction handle 20 as detailed below.The support rail 312 may include an additional a device support 330 thatsupports the cable 18 above the retraction handle 20. The rail system300 is disclosed in greater detail below.

The telescopic EWC handle 15 connects to the bronchoscope 11 and is incommunication with an EWC 96, formed internally therein, such thatinstruments passed through the telescopic EWC handle 15 pass through theEWC 96. The proximal end 16 of the telescopic EWC handle 15 includes amating feature that is engaged by the retraction handle 20. Theretraction handle 20 mates with the proximal end 16 of the telescopicEWC handle 15 (FIG. 1 ) enabling movement of the EWC 96 relative to theablation probe 19, as described below. The retraction handle 20 mayinclude an engagement feature 27 (FIG. 2 ) for engaging the matingfeature of the proximal end 16 of the telescopic EWC handle 15. Theengagement feature 27 may be a clip that is received within an openingdefined in the proximal end 16 of the telescopic EWC handle 15.

With reference to FIGS. 2 and 3 , the ablation catheter assembly 100includes an ablation probe 19 and a catheter hub 180 positioned within athrough passage 23 (FIG. 4 ) formed in the retraction handle 20. Theablation probe 19 extends distally from the catheter hub 180, throughthe telescopic EWC handle 15 (FIG. 1 ) and the EWC 96 formed internaltherein, and to a distal end 96 a (FIGS. 12 and 13 ) of the EWC 96. Thecatheter hub 180 includes coolant channels 183 and a connector 186enabling electrical connection of cable 18 with an antenna 187,described below. One of the coolant channels 183 a is an inflow channeland the other coolant channel 183 b is an outflow channel. The coolantchannels 183 a, 183 b, the connector 186, and the antenna 187 arecoupled together within the catheter hub 180 into the ablation probe 19.

With particular reference to FIG. 3A, the ablation probe 19 includes amicrowave antenna 82 electrically connected to cable 18 and sized bereceived within an outer sheath 84 of the ablation probe 19. An innersheath 86 is formed within the outer sheath 84 and surrounds themicrowave antenna 82, the inner sheath 86 separates the interior of theablation probe 19 into inflow and outflow coolant paths 83 a and 83 bsuch that coolant flows through the inflow channel 183 a, along themicrowave antenna 82 in the inflow coolant path 83 a to a distal end ofthe ablation probe 19, and returns via the outflow coolant path 83 bseparating the inner sheath 86 from the outer sheath 84 to the outflowchannel 183 b. In this manner the ablation probe 19, and moreparticularly the microwave antenna 82, is actively cooled. Examples ofmicrowave antenna construction may be found in commonly assigned U.S.patent application Ser. No. 13/835,283 entitled “Microwave Energy-Deviceand System,” and Ser. No. 13/836,519 entitled “Microwave AblationCatheter and Method of Utilizing Same,” the entire contents of each isincorporated herein by reference.

Referring back to FIG. 3 , the catheter hub 180 includes a threadedportion 189 adjacent a distal end thereof. The threaded portion 189receives an adjustment nut 182 that adjusts the length of the ablationprobe 19 extending from the retraction handle 20. The adjustment nut 182may be used by the manufacturer of the retraction handle 20 to finelyadjust the length of the ablation probe 19 extending from the retractionhandle 20 when the retraction handle 20 is assembled over the cable 18.Such an adjustment mechanism may allow the manufacturer to employincreased tolerances in the length of the ablation probe 19 duringmanufacture and to finely adjust the length of the ablation probe 19during assembly. It will be appreciated that once the retraction handle20 is assembled over the catheter hub 180, the adjustment nut 182 is notaccessible by a clinician using the retraction handle 20 (i.e., once thelength of the ablation probe 19 is set during assembly, the length ofthe ablation probe is fixed).

With additional reference to FIG. 4 , the retraction handle 20 includesa nose cone 22, a retraction control 24, a sleeve 124 (FIG. 3 ), ahandle body 26, a spindle cap 28, and a locking mechanism 30. Thecomponents of the retraction handle 20 (e.g., the nose cone 22, theretraction control 24, the handle body 26, and the spindle cap 28) maybe rotatable relative to one another to allow the components to rotatewithout applying a rotational force to the cable 18 or the EWC 96.

The handle body 26 includes first and second body sections 131, 132(FIG. 3 ) that are secured together to define a second portion 23 b(FIG. 4 ) of the through passage 23 therethrough. As shown in FIG. 3 ,the distal end of the handle body 26 defines a ring groove 133 in anouter surface thereof that receives a ring 134 that secures the firstand second body sections 131, 132 together. The distal end of the handlebody 26 is received in the first portion 23 a of the through passage 23defined by the nose cone 22. The second portion 23 b of the throughpassage 23 defined by the handle body 26 includes a nut recess 135 thatis positioned adjacent a distal end thereof and a cable recess 136 thatis positioned adjacent a proximal end thereof.

The outer surface of the handle body 26 includes mating tabs 137positioned at a proximal end thereof. The spindle cap 28 is disposedover the proximal end of the handle body 26 and includes retention tabs29 that engage the mating tabs 137 of the handle body to secure thespindle cap 28 to the handle body 26 and to secure the proximal end ofthe first and second body sections 131, 132 together.

Referring to FIGS. 4 and 5 , the nose cone 22 defines an outer wall 122and receives a sleeve 124. The sleeve 124 defines a first portion 23 aof a through passage 23 that receives the handle body 26 and a portionof the probe 19 therewithin. The outer wall 122 of nose cone 22 and thesleeve 124 define a control channel 123 therebetween that slidablyreceives the retraction control 24. The distal end of the controlchannel 123 includes a control stop 125 that may limit the proximaldisplacement of the retraction control 24 relative to the nose cone 22.

The sleeve 124 includes a first opening 126 and a second opening 128positioned distal to the first opening 126. The sleeve 124 mayoptionally define a slot 127 in communication with the first and secondopenings 126, 128 parallel to the longitudinal axis. The sleeve 124includes a retention ring 129 a disposed about the inner wall 124adjacent a proximal end thereof that prevents the retention control 24from disengaging the sleeve 124 of (i.e., sliding proximally off of thesleeve 124). The sleeve 124 is formed separately from the nose cone 22and joined thereto by a distal retention ring 129 b. It is also withinthe scope of this disclosure that the sleeve 124 may be integrallyformed with the nose cone 22.

The retraction control 24 includes a proximal flange 141 and a distalfinger 145 extending therefrom. The proximal flange 141 includes aninner angled surface 142 and a shoulder 143. The distal finger 145includes a ramped surface 146 adjacent the inner wall 124 of the nosecone 22. The distal finger 145 is positioned over the inner wall 124 ofthe nose cone 22 such that the distal finger 145 is disposedsubstantially between the sleeve 124 and the outer wall 122 of the nosecone 22.

Referring in particular to FIG. 4 , a locking mechanism 30 selectivelylocks the nose cone 22 in each of an extended position and a retractedposition as detailed below. The outer surface of the handle body 26defines pin slots 138 positioned adjacent a distal end thereof which maybe positioned proximal to the nut recess 135. The locking mechanism 30includes a locking pin 32 disposed within each of the pin slots 138 anda pin biasing member 37 supported within each of the pin slots 138between a respective locking pin 32 and the housing body 26. Eachlocking pin 32 includes a shaft 33, a retention plate 34, and a lockingsurface 35 and is disposed substantially within a respective pin slot138. The shaft 33 may pass through the pin biasing member 37. Each pinbiasing member 37 engages the retention plate 34 of a respective lockingpin 32 to urge the respective locking pin 32 out of pin slot 138.

The locking pins 32 are moveable between a locked position and anunlocked position. In the locked position, the locking surface 35 of thelocking pin 32 protrudes from the pin slot 138 and through one of thefirst and second openings 126, 128 of the sleeve 124. In the lockedposition, the retention plate 34 engages the inner surface of the sleeve124 adjacent one of the first and second openings 126, 128 to preventthe locking pin 32 from passing entirely through the first or secondopenings 126, 128. In the unlocked position, the locking pin 32 is movedtowards the longitudinal axis of the handle 20 against the pin biasingmember 37 such that the locking surface 35 of the locking pin 32 isdeflected within the inner surface of the sleeve 124. In the unlockedposition (FIG. 6 ), the locking surface 35 of the locking pin 32 isengaged by the inner surface of sleeve 124 between the first and secondopenings 126, 128.

When the locking pins 32 are in the locked position and positioned toprotruded through the first openings 126 (FIGS. 4 and 5 ), the nose cone22 is in the extended position. When the locking pins 32 are in thelocked position and positioned to protrude through the second openings128 (FIGS. 7 and 8 ), the nose cone 22 is in the retracted position. Theretraction control 24 engages the locking surface 35 of the locking pins32 to move the locking pins 32 from the locked position to the unlockedposition to permit the nose cone 22 to move between the extended andretracted positions as detailed below.

Referring to FIGS. 4-9 , the retraction control 24 moves the nose cone22 along the longitudinal axis from an extended position (FIG. 4 ) to aretracted position (FIG. 8 ). It will be appreciated that the extendedand retracted positions refer to the location of the distal end 96 a ofthe EWC 96 relative to the distal end 19 a of the probe 19 as shown inFIGS. 12 and 13 . In FIGS. 4 and 12 , the EWC 96 is extended beyond thedistal end 19 a of the probe 19, and in FIGS. 5 and 13 the EWC 96 isretracted, exposing the distal end 19 a of probe 19. In part thisorientation of movement is necessary when, as shown in FIG. 1 , thehousing body 26 of handle 20 is secured to the rail system 300 by devicesupports 330. The retraction control 24 has a first position (FIG. 4 )relative to the nose cone 22 such that the retraction control 24 (i.e.,the distal finger 145) is positioned over the second openings 128 formedin the sleeve 124 leaving the first openings 126 unobstructed and asecond position (FIG. 6 ) relative to the nose cone 22 such that theretraction control 24 (i.e., the proximal flange 141) is positionedproximal to the first openings 126 leaving the second openings 128unobstructed. Initially referring to FIGS. 4 and 5 , the nose cone 22 isin the extended position, the retraction control 24 in a first positionrelative to the nose cone 22, and the locking pins 32 are in the lockedposition within the first openings 126.

Referring now to FIGS. 6 and 7 , the nose cone 22 remains in theextended position and the retraction control 24 is moved to the secondposition relative to the nose cone 22 that is proximal to the firstposition. As the retraction control 24 is moved to the second position,the inner angled surface 142 of the proximal flange 141 engages thelocking surface 35 of the locking pins 32 to move the locking pins 32from the locked position to the unlocked position. When the locking pins32 are in the unlocked position, the nose cone 22 is free to movetowards the retracted position (FIG. 8 ).

With reference to FIGS. 8 and 9 , additional retraction of theretraction control 24 stops when the inner angled surface 142 of theretraction control 24 engages retention ring 129 a fixed to the innerwall 124 stopping the movement of the nose cone 22 proximally over thehousing body 26. As the nose cone 22 is retracted, the retractioncontrol 24 remains in the second position relative to the nose cone 22and the locking surface 35 of the locking pins 32 slide along the innersurface of the sleeve 124 between the first and second openings 126,128. When the nose cone 22 reaches the retracted position (FIG. 8 ), thelocking surface 35 of the locking pins 32, being urged by the pinbiasing members 37, extend through the second openings 128 such that thelocking pins 32 are in the locked position to fix the nose cone 22 inthe retracted position.

Now with reference to FIGS. 4, 5, and 8-11 , the movement of the nosecone 22 from the retracted position (FIG. 8 ) to the extended position(FIG. 4 ) will be described in accordance with this disclosure.Referring initially to FIGS. 8 and 9 , the nose cone 22 is in theretracted position, the retraction control 24 is in the second position,and the locking pins 32 are disposed in the locked position within thesecond openings 128 formed in the sleeve 124.

With particular reference to FIGS. 10 and 11 , the nose cone 22 remainsin the retracted position as the retraction control 24 is moved to thefirst position relative to the nose cone 22 to unlock the locking pins32. When the retraction control 24 is moved from the second position tothe first position, the ramp 146 of the distal finger 145 engages thelocking surface 35 of the locking pins 32 to move the locking pins 32against the pin biasing member 37 and towards the unlocked position. Thedistal finger 145 engages the control stop 125 to limit the distaltranslation of the retraction control 24 relative to the nose cone 22.Additionally or alternatively, the shoulder 143 of the proximal flange141 may engage the proximal end of the outer wall 122 to limit thedistal translation of the retraction control 24 relative to the nosecone 22.

Referring back to FIGS. 4 and 5 , continued distal movement of theretraction control 24 moves the nose cone 22 distally relative to thehousing body 26 to move the nose cone 22 to the extended position. Thedistal finger 145 may engage the control stop 125 or the shoulder 143 ofthe proximal flange 141 may engage the proximal end of the outer wall122 to move the nose cone 22 to the extended position. As the nose cone22 is extended, the retraction control 24 remains in the first positionrelative to the nose cone 22 and the locking surface 35 of the lockingpins 32 slide along the inner surface of the sleeve 124 between thefirst and second openings 126, 128. When the nose cone 22 reaches theextended position, the locking surface 35 of the locking pins 32, beingurged by the pin biasing members 37, extend through the first openings126 such that the locking pins 32 are in the locked position to fix thenose cone 22 in the extended position.

With reference to FIGS. 1 and 14-18 , the rail system 300 mounts to abronchoscope (e.g., bronchoscope 11) to support instruments insertedthrough and associated with the bronchoscope (e.g., ablation catheterassembly 100). The rail system 300 is configured to separately supporteach instrument inserted through the bronchoscope and associatedcabling, where necessary. While the rail system 300 detailed herein isdescribed for use with a bronchoscope and associated instruments, it iscontemplated that the support system may be used with other devices andassociated instruments.

Referring now to FIGS. 1, 14, and 15 , the rail system 300 includes arail 312, a lower support 320, and a device support 330. The lowersupport 320 includes a support body 322 that mounts to a bronchoscope 11to support the rail 312. The rail 312 has a lower end 316 and an upperend 318 and defines a longitudinal axis therebetween.

The support body 322 includes support fingers 324 and defines a railopening 327 that is sized and configured to receive the lower end 314 ofthe rail 312. The support fingers 324 extend from the rail opening 327in a direction orthogonal to the rail opening 327 and around a portionof the bronchoscope 11. The support fingers 324 define a support opening323 therebetween that mates with the portion of the bronchoscope 11.Each support finger 324 defines a through locking hole 325 aligned withthe locking hole of the other finger 324. A locking member 326 isinserted through the locking holes 325 to compress the support opening323 about the portion of the bronchoscope 11 which secures the supportbody 322 to the bronchoscope 11. It is contemplated that the supportopening 323 may compress about the telescopic EWC handle 15.

With reference to FIGS. 14 and 15 , a collar 316 is disposed over thelower end 314 of the rail 312 and within the rail opening 327. The railopening 327 and the collar 316 may be threadably coupled to one another.A thread portion of the collar 316 extends from the rail opening 327. Asecurement member 317 is threaded over the threaded portion of thecollar 316 extending from the rail opening 327. The securement member317 radially compresses the collar 316 against the rail 312 to securethe rail 312 within the rail opening 317. It is also contemplated thatthe distal end 314 of the rail 312 may be threaded and configured tothread directly into the lower support 320 without the collar 316. Insuch embodiments, the securement member 317 may be a lock nut to

The rail 312 extends vertically from the lower support 320 towards theupper end 318. The rail 312 may be fully supported by the lower support320 or a support (not shown) may be releasably coupled adjacent theupper end 318 to provide additional support to the rail 312. The rail312 may be constructed of any suitable material including, but notlimited to, surgical steel, fiberglass, and plastic.

Referring to FIGS. 16-18 , one or more device supports 330 arepositioned along the rail 312 and configured to support instruments(e.g., handle 20, cable 18 of ablation catheter 100) inserted throughthe bronchoscope 11. The device support 330 includes a clamp arm 331having a clamp arm collar 332, which defines a rail passage 333therethrough. The clamp arm collar 332 is sized and configured to slideover the rail 312 in an unlocked configuration and to engage the rail312 in a locked configuration to fix the device support 330 in positionalong the rail 312. In the unlocked configuration the rail passage 333is sized and configured to freely slide over the rail 312 and in thelocked configuration the rail passage 333 is sized and configured toengage the rail 312. In the locked configuration, the device support 330may be longitudinally and/or radially fixed to the rail 312.

The device support 330 includes instrument fingers 334 extending fromthe clamp arm collar 332 in a direction orthogonal to the longitudinalaxis of the rail 312. The instrument fingers 334 define an instrumentpassage 335 therebetween that is sized and configured to releasablycouple to and to support an instrument (e.g., handle 20, ablationcatheter assembly 18).

The device support 330 further includes a locking arm 336 thattransitions the clamp arm collar 332 between the locked and unlockedconfigurations. The locking arm 336 includes a locking arm collar 337that is disposed over a portion of the clamp arm collar 332 and includesa locking cam 338. The locking cam 338 extends from the locking armcollar 337 substantially parallel to the longitudinal axis of the rail312 and towards the clamp arm 331. A portion of the clamp arm collar 332includes a radial camming surface 339. The camming surface 339 forms aradial ramp such that as the locking arm 336 is rotated from an unlockedposition (FIG. 17 ) towards a locked position (FIG. 18 ), the lockingcam 338 engages the camming surface 339 to compress the clamp arm collar332 towards the locked position. The locking cam 337 may engage theclamp arm 331 in one of the locked or unlocked positions of the lockingarm 336 to prevent the locking arm 36 from excessive rotation about theclamp arm collar 332 and to provide indicia (e.g., tactile, visual, oraudible indicia) that the device support 330 is in the locked orunlocked position.

In embodiments, the locking arm collar 337 may include two locking cams338 radially disposed about the locking arm collar 337 about 180° apartas shown in FIGS. 17 and 18 . One of the locking cams 337 may engage theclamp arm 331 in the locked configuration and the other of the lockingcams may engage the clamp arm 331 in the unlocked configuration toprevent the locking arm 336 from excessive rotation about the clamp armcollar 332 and to provide indicia (e.g., tactile, visual, or audibleindicia) that the device support 330 is in the locked and unlockedconfiguration.

In use, the support fingers 324 of the lower support are slid over aportion of the bronchoscope 11 such that the portion of the bronchoscope11 is positioned within the opening 323. A locking member 326 isinserted through the locking holes 325 of the support fingers 324 andtightened to lock the lower support 320 to the bronchoscope 11.

The lower end 314 of the rail 312 is inserted into the rail opening 327defined in the lower support 320. The lower end 314 may be inserted intothe collar 316 disposed within the rail opening 327. The securementmember 317 is tightened over the threaded portion of the collar 316 tosecure the rail 312 to the lower support 320. The upper end 318 of therail 312 may be coupled to a support (not shown) to provide additionalsupport to the bronchoscope 11. It is contemplated that the support maybe a support stand supported on from the floor, a support hanging from aceiling, or a support extending from a wall.

A catheter (e.g., ablation catheter assembly 100) is then insertedthrough the telescopic EWC handle 15 and the EWC 96. A proximal end ofthe ablation catheter assembly 100 may include a catheter collar (notshown) positioned on the outer surface of the cable 18 for engagementwith a device support 330 or the device support 330 may clamp directlyto an outer surface of the cable 18, as shown.

A first device support 330 is positioned along the rail 312 such thatthe instrument passage 335 of the first device support 330 is adjacent aportion of ablation catheter assembly 100 (e.g., the catheter collar orthe cable 18). The portion of the ablation catheter assembly 100 is thencoupled to the clamp arm 332 by urging the portion of ablation catheterassembly 100 into the instrument passage 335. The first device support330 is then locked in position on the rail 312 by moving the lock arm336 of the first device support 330 to the locked position. When theportion of the ablation catheter assembly 100 is secured within theinstrument passage 335 with the device support 330 in the lockedconfiguration, the portion of the ablation catheter assembly 100 issupported by the first device support 330. It is contemplated that thefirst device support 330 may be locked prior to urging the portion ofthe ablation catheter assembly 100 into the instrument passage 435.

With reference to FIG. 19 , an electromagnetic navigation (EMN) system400 is provided in accordance with this disclosure. FIG. 19 also depictsthe ablation catheter assembly 100, the cable 18 (which connects on oneend to a microwave generator (not shown) and on the other end to) thehandle 20, and the rail system 300 of FIG. 1 for use with the EMN system400. One such EMN system is the ELECTROMAGNETIC NAVIGATION BRONCHOSCOPY®system currently sold by Covidien LP. Among other tasks that may beperformed using the EMN system 400 are planning a pathway to targettissue, navigating a catheter guide assembly to the target tissue,deploying an instrument adjacent or into the target tissue to treat orcapture the target tissue, digitally marking the location of the targettissue in a data file related to the planned pathway, and placing one ormore echogenic markers at or around the target tissue.

The EMN system 400 generally includes an operating table 410 configuredto support a patient; the bronchoscope 11 configured for insertionthrough the patient's mouth and/or nose into the patient's airways; atracking system 470 including a tracking module 472, a plurality ofreference sensors 474, and an electromagnetic field generator 476; and aworkstation 480 including software and/or hardware used to facilitatepathway planning, identification of target tissue, navigation to targettissue, and digitally marking the biopsy location.

Before an ablation procedure can be performed, a locatable guide (LG)catheter 492, including an electromagnetic (EM) sensor 494, is insertedinto the telescopic handle 15, and connected to rail system 300. Uponinsertion into the telescopic EWC handle 15, the LG catheter 492 entersthe EWC 96 and is locked into position such that the sensor 494 ispositioned slightly beyond the distal end 96 a of the EWC 96 duringplacement of the EWC 96. The location of the EM sensor 494, and thus thedistal end 96 a of the EWC 96, within an electromagnetic field generatedby the electromagnetic field generator 476 can be derived by thetracking module 472, and the workstation 480. During insertion andplacement of the distal end 96 a of the EWC 96, the telescopic EWChandle 15 and the LG catheter 492 inserted therein can be manipulated byrotation and compression to steer and position the LG catheter 492. Anexample of a similar catheter guide assembly is currently marketed andsold by Covidien LP under the name EDGE′ Procedure Kits. For a moredetailed description of the use of the catheter guide assembly referenceis made to commonly-owned U.S. Provisional Patent Application Ser. No.62/020,240 filed on Jul. 2, 2014 and entitled System and Method forNavigating within the Lung, the entire contents of which are herebyincorporated by reference.

Once the LG catheter 492 and EM Sensor 494 are navigated to a targetwithin the patient, the LG catheter 492 is removed from the EWC 96,bronchoscope 11, and telescopic EWC handle 15, and an ablation cathetersystem 100 may be inserted to treat the tissue at the target. When theEWC 96 is positioned, the bronchoscope 11 is held steady as the LGcatheter 492 and the EM sensor 494 are withdrawn from the EWC 96 and theablation catheter assembly 100 is inserted through the EWC 96 until thedistal end 19 a of the ablation probe 19 is adjacent the distal end ofthe EWC 96. In this configuration the ablation catheter assembly 100,handle 20, and rail system 300 have substantially the orientationdepicted in FIG. 1 . The handle 20 is then manipulated to retract andextend the EWC 96 as detailed above to permit the clinician to treat thetarget. The ablation catheter assembly 100 is then withdrawn from theEWC 96 permitting additional instruments to be inserted through the EWC96, the EWC 96 to be relocated to another target, or the EWC 96 to beremoved from the airway of the patient.

In one embodiment, the EM sensor 494 may be disposed on a distal end 19a the ablation probe 19. During insertion and positioning of theablation probe 19 and EM sensor 494, the handle 20 is in the extendedposition (FIG. 4 ) such that the distal end 19 a of the ablation probe19 is substantially within the EWC 96 as shown in FIG. 12 . In addition,ablation probe 19 and the handle 20 may be secured to the bronchoscope11 with the rail system 300, as detailed above, such that as a clinicianmanipulates the telescopic EWC handle 15, the ablation probe 19 c andthe handle 20 move in concert together with the telescopic EWC handle 15permitting one-handed manipulation of the bronchoscope 11, thetelescopic EWC handle 15, the ablation catheter assembly 18, and thehandle 20.

When the EM sensor 494 is positioned adjacent the target, the handle 20is moved to the retracted position (FIG. 10 ) to retract the EWC 96 suchthat the distal end 19 a of the ablation probe 19 is exposed as shown inFIG. 13 . With the distal end 19 a of the ablation probe 19 exposed, theablation probe 19 may be activated to treat the target. After the targetis treated, the handle 20 is returned to the extended position such thatthe distal end 19 a of the ablation probe 19 is substantially within theEWC 96 (FIG. 12 ). The ablation catheter assembly 100 may then beremoved from the EWC 96 leaving the distal end of the EWC 96 adjacentthe target. Additional instruments may then be passed through the EWC 96to treat the target, the EWC 96 may be relocated to another target, orthe EWC 96 may also be removed from the airway of the patient.

As described above, the rail system 300 and EMN system 400 may be usedin combination with an LG catheter 492 or an ablation catheter 100.However, other instruments may also benefit from the rail system 300.Examples of additional instruments that may be inserted through the EWC96 to treat and/or sample the target are shown in FIGS. 20A-20C,depicting biopsy forceps 670, a biopsy brush 675, and a biopsy needle680. As shown in FIG. 20 , each instrument includes an EM sensor 494disposed thereon in accordance with this disclosure, however,instruments without EM sensors 494 may also be employed withoutdeparting from the scope of this disclosure. A proximal end of theinstruments 670, 675, 680 may include a handle 20 similar inconstruction to what is shown in FIGS. 1-11 , enabling the retractionand extension of the EWC 96.

Referring to FIGS. 21-27 , another rail system 500 is provided inaccordance with this disclosure and includes a rail 512, a lower support520, and a device support 530. The rail system 500 is similar instructure and function to the rail system 300 detailed above, as suchonly the differences will be detailed herein for reasons of brevity. Thelower support 520 includes a support body 522 that is coupled to a loweror distal end 514 of the rail 512 and defines a rail opening 529 (FIG.23 ) that receives the lower end of the rail 512 therein. The lowersupport 520 may include a collar 516 positioned in or adjacent to therail opening 529 that engages an outer surface of the rail 512 to securethe lower support 520 to the rail 512.

The support body 522 of the lower support 520 extends from the railopening 529 to a support arm 524 that has a clamped configuration (FIGS.22 and 23 ) and an open configuration (FIGS. 24 and 25 ). The supportarm 524 and the support body 522 define a support opening 523 that isconfigured to receive and clamp to a bronchoscope 11 (FIG. 1 ) using abronchoscope adapter 511 to secure the lower support 520 to thebronchoscope 11. The bronchoscope adapter 511 may be threaded to aworking channel port on the bronchoscope 11 as is known in the art. Thesupport arm 524 pivots about a pivot pin 528 to transition between theclamped and open configurations thereof. The support arm 524 includes aclip 526 and the support body 522 defines a clip detent 525 (FIG. 25 )that is configured to selectively receive the clip 526 to secure thesupport arm 524 in the clamped configuration. The clip 526 may providetactile feedback when the clip 526 is secured in the clip detent 525.The bronchoscope adapter 511 may include an annular ring 511 a and theinner surface of the support opening 523 may define an annular groove527 that is sized to receive the annular ring 511 a to longitudinallyfix the lower support 520 to the bronchoscope adapter 511 when thesupport arm 524 is in the clamped configuration. It is contemplated thatthe cooperation of the annular ring 511 a and the annular groove 527 mayassist in aligning the lower support 520 with the bronchoscope 11 (FIG.1 ).

It is also contemplated that the annular ring 511 a and the annulargroove 527 may only be defined along a portion of the support opening23. In such embodiments, the cooperation of the annular ring 511 a andthe annular groove 527 may radially fix the lower support 520 to thebronchoscope adapter 511.

With particular reference to FIGS. 26 and 27 , the device support 530includes a support collar 532 slidably disposed over the rail 512,instrument fingers 534 extending therefrom, and a locking mechanism 540disposed therein. The locking mechanism 540 includes a locking arm 541having locking cams 542. The locking arm 541 is pivoted between anunlocked position (FIG. 26 ) and a locked position (FIG. 27 ) to actuatethe locking mechanism 540 between an unlocked configuration and a lockedconfiguration. It will be appreciated that the locking arm 541 includesa passage that permits support collar 532 and the locking mechanism 540to slide on the rail without engaging the rail 512 when the locking arm541 is in the unlocked position. As shown, the locking mechanism 540 hasupper and lower mechanisms that are substantially similar to one anotherand function in concert with one another; however, it is contemplatedthe locking mechanism 540 may only include either the upper or lowermechanism or that the each of the upper and lower mechanisms may beindependently actuated.

The locking mechanism 540 further includes an outer member 544 and aninner member 548 coaxially positioned with one another about the rail512. The outer member 544 and the inner member 548 are moveable relativeto one another between an unlocked position (FIG. 26 ) and a lockedposition (FIG. 27 ). The outer member 544 may be biased towards theunlocked position by a biasing member 546. The outer member 544 includesa camming surface 549 that is engaged by the locking cam 542 of thelocking arm 541.

To fix the device support 530 to the rail 512, the locking arm 541 ispivoted from the unlocked position (FIG. 26 ) to a locked position (FIG.27 ). As the locking arm 541 is pivoted, the locking cams 542 cam theouter member 544 against the biasing member 546 and over the innermember 548 such that inner angled surfaces of the outer member 544engage outer angled surfaces of the inner member 548 such that the innermember 548 is radially compressed into the rail 512 to engage the rail512. It is contemplated that the inner member 548 may include teeth 548a that engage the rail 512 to fix the inner member 548 to the rail 512.The inner member 548 is coupled to the support collar 532 such that whenthe inner member 548 is fixed to the rail 512, the support collar 532and thus the device support 530 is fixed to the rail 512. It iscontemplated that the inner member 548 may be integrally formed with thesupport collar 532.

As described above, the rail system 500 may include device support 530.However, other device supports may be used in combination with the railsystem 500 which are configured to support a variety of instrumentsinserted through the EWC 96. For example, as shown in FIG. 28 anadditional device support 550 is illustrated in use with rail system500. The device support 550 includes a support collar 532 and instrumentfingers 554 extending therefrom. The instrument fingers 554 aresubstantially similar to the instrument fingers 354 detailed above withrespect to device support 330.

While the use of the handle 20 and the rail system 300, 500 are detailedherein for use in the airway of a patient, it is contemplated that thehandle 20 and/or the rail system 300 may be used in a variety ofsurgical procedures utilizing elongated surgical instruments withextended working channels. For example, the handle 20 and or rail system300, 500 may be used to stabilize a guide wire or catheter duringvarious endovascular procedures such as cardiac interventions, generalvascular interventional procedures, cerebral interventions, etc. Theseprocedures may include, but are not limited to, balloon dilations, stentplacements, percutaneous valve replacement, percutaneous valve repair,pacing lead placement, cardiac ablation procedures, and electricalmapping procedures.

While several embodiments of the disclosure have been shown in thedrawings, it is not intended that the disclosure be limited thereto, asit is intended that the disclosure be as broad in scope as the art willallow and that the specification be read likewise. Any combination ofthe above embodiments is also envisioned and is within the scope of theappended claims. Therefore, the above description should not beconstrued as limiting, but merely as exemplifications of particularembodiments. Those skilled in the art will envision other modificationswithin the scope and spirit of the claims appended hereto.

What is claimed:
 1. A microwave ablation catheter system, comprising: amicrowave ablation catheter configured for navigation within airways ofa patient; a distal handle including a longitudinal through passageconfigured to receive the microwave ablation catheter; a proximal handleslidably disposed within the longitudinal through passage of the distalhandle such that the distal handle is movable over the proximal handle;a locking mechanism coupled to the distal handle and configured toprevent movement of the distal handle relative to the proximal handle;and an engagement interface extending from the distal handle andconfigured to releasably attach the distal handle to a navigationcatheter configured to receive the microwave ablation catheter forplacement of the microwave ablation catheter at a target within thepatient.
 2. The microwave ablation catheter system according to claim 1,wherein the longitudinal through passage is defined by a sleeve housedwithin the distal handle.
 3. The microwave ablation catheter systemaccording to claim 1, wherein the microwave ablation catheter includesan inner sheath surrounding a coaxial cable and an outer sheathsurrounding the inner sheath.
 4. The microwave ablation catheter systemaccording to claim 3, further comprising: an inflow lumen definedbetween the coaxial cable and the inner sheath and configured to receivea cooling fluid; and at least one outflow lumen disposed between theinner sheath and the outer sheath and configured to receive the coolingfluid.
 5. The microwave ablation catheter system according to claim 4,further comprising an additional inflow lumen disposed between the innersheath and the outer sheath and configured to receive the cooling fluid.6. The microwave ablation catheter system according to claim 4, whereinthe at least one outflow lumen includes two outflow lumens disposedbetween the inner sheath and the outer sheath.
 7. The microwave ablationcatheter system according to claim 1, further comprising a cable atleast partially disposed within the proximal handle and configured tocouple the microwave ablation catheter to a microwave energy source. 8.The microwave ablation catheter system according to claim 7, wherein thecable is further configured to couple the microwave ablation catheter toa fluid source for delivering cooling fluid to a distal portion of themicrowave ablation catheter.
 9. The microwave ablation catheter systemaccording to claim 1, wherein the locking mechanism includes a lockingpin disposed within a slot defined by the proximal handle, the lockingpin having a locked position in which the proximal and distal handlesare fixed relative to one another and an unlocked position in which thedistal handle is movable over the proximal handle.
 10. The microwaveablation catheter system according to claim 1, wherein the engagementinterface includes a clip extending from a distal end portion of thedistal handle, the clip configured to be received within an opening inthe navigation catheter to removably attach the distal handle to thenavigation catheter.
 11. A microwave ablation catheter system,comprising: a microwave ablation catheter configured for navigationwithin airways of a patient; a distal handle including a longitudinalthrough passage configured to receive the microwave ablation catheter; aproximal handle slidably disposed within the longitudinal throughpassage of the distal handle such that the distal handle is movable overthe proximal handle; and a clip extending from the distal handle andconfigured to releasably attach the distal handle to a navigationcatheter configured to receive the microwave ablation catheter forplacement of the microwave ablation catheter at a target within thepatient.
 12. The microwave ablation catheter system according to claim11, wherein the microwave ablation catheter includes an inner sheathsurrounding a coaxial cable and an outer sheath surrounding the innersheath.
 13. The microwave ablation catheter system according to claim11, further comprising a locking mechanism coupled to the distal handleand configured to prevent movement of the distal handle relative to theproximal handle.
 14. The microwave ablation catheter system according toclaim 11, further comprising a cable at least partially disposed withinthe proximal handle and configured to couple the microwave ablationcatheter to a microwave energy source.
 15. The microwave ablationcatheter system according to claim 14, wherein the cable is furtherconfigured to couple the microwave ablation catheter to a fluid sourcefor delivering cooling fluid to a distal portion of the microwaveablation catheter.
 16. The microwave ablation catheter system accordingto claim 11, wherein the clip is configured to be removably receivedwithin an opening defined by the navigation catheter to releasablyattach the distal handle to the navigation catheter.
 17. A microwaveablation catheter system, comprising: a microwave ablation catheterconfigured for navigation within airways of a patient; a distal handleincluding a longitudinal through passage configured to receive themicrowave ablation catheter; a proximal handle slidably disposed withinthe longitudinal through passage of the distal handle such that thedistal handle is movable over the proximal handle to place the microwaveablation catheter at a target within the patient; and a lockingmechanism coupled to the distal handle and configured to preventmovement of the distal handle relative to the proximal handle.
 18. Themicrowave ablation catheter system according to claim 17, furthercomprising a cable at least partially disposed within the proximalhandle and configured to electrically couple the microwave ablationcatheter to a microwave energy source.
 19. The microwave ablationcatheter system according to claim 18, wherein the cable is furtherconfigured to couple the microwave ablation catheter to a fluid sourcefor delivering cooling fluid to a distal portion of the microwaveablation catheter.
 20. The microwave ablation catheter system accordingto claim 17, wherein the locking mechanism includes a locking pindisposed within a slot defined by the proximal handle, the locking pinhaving a locked position in which the proximal and distal handles arefixed relative to one another and an unlocked position in which thedistal handle is movable over the proximal handle.